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Firm handling the information exchange interaction by parents/guardians in paediatric care: An observational study
Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.ORCID iD: 0000-0003-1588-135X
Linköping University, Department of Medicine and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
(English)Manuscript (Other academic)
Abstract [en]

Background. Health care professionals need further background knowledge to encounter the parents/guardians from their perspective in their minors’ health care. The parents/guardians possibility to manage the situations is dependent on their receiving optimal information, which is why it is important to study how information is exchanged.

Objective. To identify, describe and conceptualize how parents/guardians resolved their main concern in information exchange with health care professionals in paediatric care situations involving their minors.

Methods. The grounded theory method was used and all data were analysed using constant comparative analysis. The observational study took place at three paediatric outpatient units at a university hospital and twenty four parents/guardians participated. Data sources were field notes from 37 observations of paediatric care situations and adherent excerpts from the minors’ medical records.

Results. Firm handling revealed as the way the parents/guardians resolved their main concerns when they were exchanging information in their minors’ paediatric care. Firm handling is built on five inter-related categories: representative advocating, collaborating, aim sharing, supportive resourcing and minor bypassing.

Conclusions. This knowledge renders possibilities to the health care professionals to design paediatric care that supports, facilitates, strengthens and improves the parents’/guardians’ firm handling. The key issue is to find ways to support parents/guardians and minors so they can participate in health care encounters according to their preferences. Firm handling give an opportunity to both reinforce parenthood in paediatric care and invite minors to participate.

National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-18003OAI: oai:DiVA.org:liu-18003DiVA: diva2:213963
Available from: 2009-04-30 Created: 2009-04-30 Last updated: 2013-09-12Bibliographically approved
In thesis
1. Information exchange in paediatric care
Open this publication in new window or tab >>Information exchange in paediatric care
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
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Abstract [en]

Information exchange is an essential component for all involved in the paediatric care encounter. Despite this, most of the research about information exchange concerns adults and the significance of the child’s existence in the encounter have not been given sufficient attention. Therefore, the overall aims of this thesis were twofold. Firstly, the aim was to identify, describe and generate concepts in information exchange between minors, parents/guardians and health care professionals in paediatric care situations. Secondly, the intention was to formulate a theoretical construction, a theory, of the phenomenon of information exchange in paediatric care situations.

This thesis is based on four studies. In studies I, II and III grounded theory was used according to Glaser and data have been analyzed using the constant comparative analysis method. Data have been collected through observations and medical records (I, II and III) and also with additional follow-up interviews (III). In study IV, at first a qualitative content analysis of Løgstrup’s ethical demand was conducted and, second, a simultaneous concept analysis of the findings from studies I, II and III and the findings from the qualitative content analysis was carried out. There were a total of 67 participants in the three observational studies: 28 minors (I), 24 parents/guardians (II) and 15 health care professionals (III), who exchanged information in different paediatric care encounters.

The information exchange interaction process was resolved by the minors “balancing the circumstances” (I), the parents/guardians used “firm handling” (II) and the health care professionals were “sharing and contributing the responsibility” (III). The qualitative content analysis of Løgstrup’s ethical demand provided the mediation and the social norms. The simultaneous concept analysis finally gave the advanced outcome to intergrade, which means to merge gradually with another through a continuous series of intermediates. At the same time as we intergrade in paediatric care, we protect the totality of minors, recognize the dependency of the parents/guardians and the social interplay by the health care professionals, the information exchange is improved. This thesis emphasizes the importance of health care professionals’ communication skills and the need for education and practice in this topic, in order to improve the information exchange with minors and their parents/guardians from an ethical viewpoint. The theory intergrade explains how this could be applied and implemented.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2009. 58 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1106
Keyword
Ethical demand, Grounded theory, Information exchange, Paediatric care, Qualitative content analysis, Simultaneous concept analysis
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-18007 (URN)978-91-7393-681-1 (ISBN)
Public defence
2009-05-15, Aulan, Länssjukhuset Ryhov, Jönköping, 13:00 (English)
Opponent
Supervisors
Available from: 2009-04-30 Created: 2009-04-30 Last updated: 2013-09-12Bibliographically approved

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Mårtenson Wikström, EvaBerterö, CarinaFägerskiöld, Astrid

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